The use of PACS provides more rapid availability of diagnostic imaging. However, such use does guarantee either that the images will be reviewed earlier than they would be with film-based operation, or as the radiologists interpretation will be provided more quickly. This project will develop and evaluate two methods that have a goal of improving the results reporting for radiological studies in selected clinical sites served by PACS. The first of these methods is aimed at overcoming one source of delay in the evaluation of radiological examinations on the part of referring physicians. This delay has been shown to be in part related to the inability of the existing system to notify the referring physicians that results are available. This project will implement by both centralized and distributed methods of such notification and determine the effects on the time between examination completion by radiology and the review of the images by the referring physicians. The second method focuses on improving both the timing and method of delivering the radiologist's interpretation of the examination to the referring physicians. The importance of this derives from our previous observations that referring physicians reduce their consultation with radiologists when using a PACS workstation for review of radiographic studies and that their error rates for some tasks are measurably higher than for radiologists performing the same reading studies. Three approaches will be implemented and evaluated with the most suitable for both referring physicians and radiologists deployed. The effects of this combined rapid delivery of images and associated reports related to delays in referring physician review will be assessed. The separate and combined effects of these two systematic changes will also be evaluated with regard to the time that the referring physicians take to act on the results.